12145 SW 123RD COURT law
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INSPECTION NOTICE
City of Tigard Building Departmen'.
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639-4171
Address------ Permit #
Type of Inspection _ _�---- --- -The followin; Building Code deficiencies are required to be c:)rrected: -- —__ - —
Presented to- - - ------ - Inspector --
Date ------ - - - --- —--
C4LL FOR REINSPEC-RON
❑ VIES CJ NO
i
BUILDING DEPARTMENT, �IGARD
PLUMBING PERMI _
,+'-- / _. -. holder of a valid t,lumbing contractors license is hereby
authorized t'o Cu-se plumbing ork as herein noted to be installed in accordance with the plumbing code of
Tigard. Such installations require inspection by tha City Inspector who shall be notified not less than four
(4) hour- -1rior to the time the installations are ready for inspection. City of Tigard Business License required
for 311 CL....ractors and sub-contractors.
Ownerl/1 A� �} ✓ /' v F '`� Addruss_12/ 5� S. �.l : v / 2 3edc bate /t'
NUMBER OF TOTAL PERMIT Nti.-t
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT IOff,ce Use Onlyl
Single FRmily--1 hath-each 25.00O h w#
Du lax-Each 1 bath unit - - "5.00
additional ynronms`�+ch_ _ ��--- ;o O .
at
M.,bule Home Space-each 15.00 _
_INniyinyAL cry tL'^IE FEES
1 to 50 Fixtures in 1 building-eoch 3.00
51 to 100 Fixtures in 1 buildin -ead — 2.5U
101 to 200 Fixtures h 1 building-each-_� 2.00 _
201 or more Fixtures it t building--each 1.50
MISCELLANEOUS
Building_Sewer-1st 50 It. 10.00
Sewer-each additional 100 ft. _ 1000
Water Service to building — 5.00
Private Water Systems-each 100 ft. 10.00
Other IS RSifVl: — —ect on 4Inspection
---
For Plumhin. ins Phone 63.7 4171
PERMIT �S O �� _ P• �
3°;State / Sl D _ _ Plumbing Contractor By
TOTAL 3 RECEIPT NO. Issued By
tIw ISI tw I� w � � tir �
BUILDING PERMIT APPLICATION TIGARD DAIS — - ---,ts__--- 334 .
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOP.. THE WORK HEREIN INr,'CATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICA"IONS. OWNER PHONE 4Ygl��f3
LUT N0.___Y fj
OWNER Thuma `.-!ubb JOB ADDRESS 12145 9.61. 123rd Ct.
97gC� ARCHITECT
ENGINEER
BUILDER Thamns Ll, SteuanS ADDRESSP•O.• Box 74 - AurarEDESIGNER —_
STRUCTURE _ ONEW _❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE` ❑ DEMOLITION
ISMESIDENCE C] COMM ❑_EDUCATIONAL ❑ GOV'T CI RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY Jin3—LAND USE ZONE 2"7 BLDG.TYPE —23—FIRE ZONE_ `" -PLAN CHECK BY DIJH- HEAT E. ti VOL—.
Construct single family t 11ing with attached garage -- --- urflp
_ See correction sheet atta0iwij 3 bedrooms
2 baths
SEWER PERMIT# 2201.1_ ,/fir'!, i r_:,r.a,,., �,7❑ ---- —_ -__---
OCC.LOAD FLOOR LOAD 40 HEIGHT 23 NO.STORIES 2 AREA 2036 NO,BEDROOMS 3 VALUE GIS GOO
BUILDING DEPARTMENT.— SET BACKS FRONT 20 REAR J 4 LEFT SIDE 16 nIGH�SIDE
Permit 22b.00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
__ REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 112.50 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
S��. Ja WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOt WAIVE
Subtotal RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 9100
SDC-- 4 U U.00
Total 346.50
PDCN: AGENT
By -- La.._-
_. Receipt No. -
Approved () _ RESB PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
'YTb ✓�� ��A ---� -- --- Contractor �— -
'� ��_��_ _'r�1► - 0 t \ ���6 I Permit No.
N•.� Rough-in
11- 3^'*0 Avo
�— �a Fixture
y� ^--`--- Final --
^� � - ---- -- ---- HEATING -
/! Contractor
to 1
Permit Na. "D
�� Ir
`jam � ,�� a Gas or Oil
Rough-in -- ----
Final — -
-------, SEWER --
-_ Final _ - --•n
DRIVEWAY
__ ~---—_-- Final — -
— — Storm Drainage — —
I _ -- (Hain Drain)Final
i _ _ _ Sidewalk
Curb 8 Street Final
ApproachB1Dt3 DEPT.FINAL. T TEMPORARY CERTIFICATE OCQ�NCY
CERTIFICATE OCCUPANCY Final
Landwft)ing
Zoning Final
� "'! ; ;++ '�t 3if.�#k��,.tM�'`+ v 11 rr r)+• tiF.:
2
I
1
BUILDING PERMIT APPLICATION TIGAP:) AAT
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN IN CATEDO)8UILDER PH0N2 678-Zf20
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND FECIFICATIOiNS, OWNER Pli ;�(�-
0," , EER16 ht4"1UP.�O10 12 SFS'Ski 12.3 --- 0�- LOT NO. O
1'J" _ JOB ADDRESS f
BUIL ER vV%10V9�1.� ADDRESS" poy 74' _ XIANOM ESIGNER
STRUCTURE ❑ REMODEL `i ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
RESIDENCE C COMM ❑ EDUCATIONAL 1:2
GOWT ❑ RELIGIOUS u PATIO C CARPORT [2 GARAGE ❑ STORAGE C] S1.p,SF—'�FFNCE
Or,CUPANC'Y LAND USEZONE (Z-7 BLDG.TYPE 'Y-N FIREZONE PLAN CHECK BY W HEAT AGtyr—__
SMIER PERM r# y7q
OCC.LOAC FLOOR LOAD HEIGHT ?3NO.STORIES 2 AREA20 3& N7.BEDROOMS 3 VALUt(,19-40to
BUILDING DEPARTMENT SET BACKS FRONT ,^
Ts
,2 REAR !yf LEFT SICE �� RIGHT SIDE
n e.40 �_ —��— - -
Pormit 2.x.7 TF',tS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THS BUILDING CODE,ZON:NG
v FEQULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED-,PAT THE
PlanCheck 2• S WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COtdPLiANCE
fp —iT--FAITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOZES NOT WAIVE:
ISub-total ' ��• S��f RESTRICTIVE COVENANTS, CONTRACTOR AND SUS CONTRACTORS TO HAVE CURRENT CITY BUSINESS
rr I UCENSE SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Stata Tax
Total _ 4(p, 0 SDC— V Uy(�l0
POC# APPLICAN T OR AGENT /�
By
Receipt No. _�
Approved - ADDRESS , PHONE -- --
5 D C -
SDC - s T
5EWE- CONNECTION
jEWER INSPECTION 2.
�-
3EWER SURCHARGE S �'
varOyto I--iT(,WYF—Ag-s
L.+#33 — 0d W° "y
Anm— ��4-
I TZ(ooY-
33YO X13, p
R�Qc,�— ?�'!� x a•Z
_2 -
,4 8 2r.tly G coo 7
___._ t --I-
2,03 _..
2 Z x 12• ��
!�lo
COOS ro
i
I
C y of Ticard Mechanical F'e�•�'rllf j�T;� emit_
Fee
New Installation ( Replan; �� Relocation ❑ Addition FJ Alteration _I
47.
HEATING TOTAL�_1�,
CONTRACTOR �+GOWNER
AcrDREssSQ.� _ass` WORK ADDRESS ����� Sj,� 1214
PHONE Z(vG-(2SL-� APPLICANT'
Heat Input Rating (BTU Per Hour)_ Q'2,Ooo _ w. Ven; Size ___ ---Flue Size 5 4
FUEL OIL Q GAS NT ELECT ❑ OTHER `(- a
ITEM NO. FLEE ITEM NO. FEE
For Issuanr_e of Permit EE ABOVE �_ _Air Condition Compressor 15 to 30 HP _ _
_New=up to incl. 00000 BTU --- _. 10.00 TO
4.00 Air Handiin 10,000 CFM 3 Od
�leril00 001 $U s - 9 - —OCC --- —_ _
_ & over 5.00 Air Handling Ovar 10 0FM +It
Floor Furn_:u - _ — - _—_ - 5.00 '" •r
4.0_0 �Evaporatire Couler -
Wall • Floor-•Suspanded _ � 4.00- -- Fienge Vent Fan' �'-""- - --___.. •d'J��, ,._
Install_Vents Only - --------_--- 2.00
2.00_ _Vent System 3.OU i
R_epair_- Float& Cooling 4.0_6 _Hood Commercial_ _- '-�
Air Cowlition Compressor_Under 3 HP
__ _ _� 4.00 Commercial Duct Systom --
Air Condition Cornpres3or 3 to 15 Hp ---- --- -- 10.00
7.50W W - �
INSPECTOR'S COMMENTS
CITY BUSINF_.SS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUB CONTRACTORS '
APPFJOVE:D By DATE _ _—_ ISSUED BY — DATE
RECEIPT NO.
114
Signature of Applicant
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